Head Support Pads for Newborns
New babies do not have enough strength in their necks to hold their heads up to keep their airways open. Their heads tend to flop sideways or forward. Placing padding alongside the baby’s head can keep it from flopping sideways. A head pad from one CR should not be used in a different CR or one from another manufacturer.

The conventional wisdom to never use a head support pad is now old advice, from the days before CR manufacturers began providing such items with their restraints. Today the situation offers more options but is also much more complex.

Support pads developed by the car seat manufacture
The pads that come with CRs are tested with those products, but there is no specific test to make sure that they actually improve newborn head positioning. Some are in the head area only but others are intended to offer full-body support. Most are optional.
If a pad does not improve the head position, it can be removed. Some have thick padding behind the head that may push the newborn’s head forward. Others have thin fabric behind the head, which is greatly preferred. Some may have side pads too widely spaced to support the new baby’s head.

Pads behind baby’s bodyPads that go behind the child’s body are offered with Chicco KeyFit, Combi Connection, and Combi Centre (the lower pad). These are intended to improve overall fit for a newborn. The Britax Companion has a low-birthweight infant insert (wedge-shaped foam) for babies under 7 pounds (for separate purchase). All have been tested and are recommended by their manufacturers to improve fit of the harness and the angle of the baby, but they are optional—and must be removed as the baby grows bigger.

Head pads that are part of the protection system
Some head-area pads look like they may be simply for newborn support but actually are part of the system of side-impact protection (SIP), such as the Britax Companion and Peg Perego Primo Viagio SIP. These should never be removed. The upper pad of the Combi Centre is part of the headrest and cannot be removed.

Support pads made by other manufacturersThese pads are not recommended for several reasons. They have not been tested with specific car seats. There are no specific tests for them (even though they may state that they have passed crash tests). Some make the harness fit too loosely or have padding behind the head that would push the newborn baby’s head forward into an unsafe position.